Angela Yaelim Chang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN015632 Issued in GA

Practice address

770 Holcomb Bridge Rd
Roswell, GA 30076

Phone

(630) 962-0871

NPI assigned

Aug 24, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Yaelim Angela Park Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1407373145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 HOLCOMB BRIDGE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761618",
            "telephone_number": "678-836-2101",
            "fax_number": "770-643-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 HOLCOMB BRIDGE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "630-962-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ANGELA",
        "middle_name": "YAELIM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YAELIM",
            "last_name": "PARK",
            "middle_name": "ANGELA",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Central Emergency Medical Services LLC
• Bailey Wilson Chambers, PA-C
• Brenda Chan, DPT, CERT. DN
• Heather M. Chandler, BCBA
• Chang Healthcare Association, Inc.
• David Chang
• Wei Yen Chang, D.D.S.
• Changing Hope Counseling LLC
• Erica Nicole Chapman, ED.D.
• Daniel B Charek, PH.D.

• Dentist in Roswell, GA
• Providers in Roswell, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.